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It Takes Two
Once the egg donor has been matched with a recipient family, the egg donation process begins.
First, the donor and recipient cycles must be coordinated. This ensures that once the eggs are fertilized the recipient's uterus is ready to receive the embryo(s). This is done by taking fertility medications to suppress hormones, such as Lupron (injections), Synarel (nasal spray), and/or birth control pills. Sometimes antibiotics are also prescribed in order to treat any undiagnosed infections.
Ovulation and Egg Development
Next, the donor begins to take additional fertility medications to cause her ovaries to produce eggs. While there are several different protocols to do this, most fertility medications are taken for at least 8 to 10 days and do involve injections. The developing eggs are carefully measured and evaluated through blood work and ultrasounds.
These eggs continue to develop until they reach a certain size and can be retrieved. Although each clinic has its own criteria, about 16 mm seems to be average. At this point, a shot of HCG is given and the egg retrieval procedure is scheduled within 35 hours.
An egg retrieval typically takes place on an outpatient basis under some sort of sedation so the patient remains as comfortable as possible throughout the procedure. A very thin needle is attached to an internal ultrasound probe which is inserted into the vagina. The doctor uses this ultrasound to see the ovaries and locate the follicles. The needle then punctures each follicle and gently suctions out the egg and the fluid within each follicle.
After the egg retrieval procedure, the recipient must rest at the clinic. She will not be allowed to drive herself home so it is important that someone accompany her. Sometimes the doctor will prescribe an antibiotic to prevent infection, a steroid to reduce any inflammation in the reproductive organs, and/or pain medications. Also, she will be told to abstain from sexual intercourse and avoid taking a bath or swimming for several days. She will also experience some vaginal bleeding.
On the date of retrieval, the recipient’s partner (or sperm donor) will also provide a semen sample. Once the semen is washed and properly prepared, the sperm is mixed with the donor’s eggs shortly after the retrieval in hopes that fertilization will occur. In many cases, ICSI is used to inject a single sperm into the egg further increasing the chance for fertilization.
The day after the eggs and sperm have been combined, the embryology lab will report on the fertilization progress. The embryos will continue to grown until they are transferred to the recipient’s uterus, which is usually somewhere between three and five days after the retrieval. The embryologist will periodically inform the recipient family with regard to the number, size, and quality of the embryos.
Based largely on the embryo quality, the recipient family will need to decide how many embryos to transfer. Any remaining embryos can be frozen for future use.